Recent studies have highlighted the significance of co-morbid STIs among HIV+ individuals but few have described their impact in chronic long-term sequelae, particularly among drug users, where primary prevention efforts might be delayed and screening practices might be nonexistent. Human papillomavirus (HPV), one of the most commonly diagnosed STIs world-wide, is of particular concern among persons living with HIV, due to the virus's oncogenic potential and the synergy of HPV infection and neoplasias with HIV coinfections. In men, not only is HPV infection associated with oral, penile and anal cancer, this risk is higher in HIV+ individuals as compared to the general population. Despite reductions in well known risk factors for oral cancers such as tobacco consumption, an augmented incidence of HPV-associated oropharyngeal cancers has been observed in the United States (US) and Puerto Rico (PR) and has been identified as an emerging viral epidemic of cancer. Using data from Dr. Col[unreadable]n-Lopez's NIDA funded study;this study will analyze oral biological specimens and conduct statistical analysis to describe the epidemiological profile of oral HPV infection among male drug users. Specific aims of this study are to: (1) describe the prevalence of oral HPV infection and HPV DNA genotype distribution in an existing sample collected among a clinic-based sample of HIV+/HIV- men 16-65 years in PR;(2) identify factors associated with increased odds of oral HPV infection, including age, HIV status and mode of drug use (IDU/non-IDU) administration;and (3) describe the relationship between prevalent oral and anogenital HPV infection. This application addresses the objectives of the AIDS-Science Track Award for Research Transition (A-START) by 1) supporting a new researcher;2) serve as a foundation for expanding research to study the intersection of drug abuse, HIV/AIDS and related comorbidities. In addition, the proposed study will characterize the epidemiology of vaccine-preventable diseases and will move research scientists into discussion and development of epidemiological and clinical studies. Also, this opportunity will provide data necessary for future R01-level studies which will further evaluate the potential impact of the HPV vaccine in a reduction of oral HPV infection and subsequent HPV-related cancer risk reduction among men who are HIV+ and also men at high- risk for HIV infection. PUBLIC HEALTH RELEVANCE: This application addresses the objectives of PA-07-34 AIDS--Science Track Award for Research Transition (A-START). It proposes to provide support to extend an existing R03 study (R03DA027939) in which I am collecting specimens for detection of human papillomavirus (HPV) infection among HIV+/HIV- drug users. Although the parent R03 study collected genital, anal, and oral specimens, its objective was to analyze only those derived from the anogenital areas of participants. Analyzing the oral samples was beyond the scope of R03-level funding. These specimens currently are held in storage and are the focus of this proposal. This investigation proposes to estimate the prevalence of oral and concurrent (anus and penis) HPV infection in HIV+/HIV- male drug users, describe the distribution of HPV types, and assess factors associated with oral HPV infection in a clinic-based sample of Puerto Rican men. Oral specimens will be analyzed and statistical analysis will be performed to evaluate risk correlates of oral HPV infection among high-risk men. The proposed study will expand scientific knowledge by employing behavioral and molecular epidemiology methodologies to understand and describe the prevalence of HPV infection and genotyping in a sample of men currently exposed to both high-risk drug and sexual-risk practices. Scientific evidence obtained from this study will serve as a foundation for expanding research to study the intersection of drug abuse, HIV/AIDS and related comorbidities, and my development of a future R01-level investigation addressing this problem.